Lu Hui, Hou Wailin
Hui Lu Department of Wound Clinic Chenzhou First People's Hospital, Chenzhou 423000, Hunan Province, P.R. China.
Wailin Hou Department of Hepatobiliary Surgery Chenzhou First People's Hospital, Chenzhou 423000, Hunan Province, P.R. China.
Pak J Med Sci. 2023 Nov-Dec;39(6):1783-1787. doi: 10.12669/pjms.39.6.7829.
To compare open and laparoscopic outcomes of adult Type-I congenital choledochal cysts.
Clinical data of 78 adult patients with Type-I congenital choledochal cysts, who had undergone cyst resection and Roux-en-Y hepaticojejunostomy in Chenzhou First People's Hospital from September 1, 2021 to August 31, 2022, were retrospectively analyzed. Patients who received open approach and Roux-en-Y hepaticojejunostomy constituted the open group (n=35,) and patients who received laparoscopic approach and Roux-en-Y hepaticojejunostomy were assigned into the laparoscopic group (n=43,). The intraoperative and postoperative conditions, relevant laboratory indicators, and the rate of complications were compared between the two groups.
Intraoperative blood loss, postoperative time to first flatus, diet recovery time, time to drainage tube removal, and length of hospitalization of the laparoscopic group were lower in the laparoscopic group compared to the open group (<0.05). One day after the operation, serum amylase (SAMY) levels in both groups were significantly lower, while the levels of total bilirubin(TBIL), alanine aminotransferase(ALT), and C-reactive protein(CRP) were higher than before the operation. Postoperative SAMY level in the laparoscopic group was significantly higher, while the postoperative TBIL and CRP levels were significantly lower than those in the open group (0.05). The incidence of postoperative complications in the laparoscopy group (4.65%) was significantly lower than the open group (20.00%) (0.05).
Laparoscopic cyst resection combined with Roux-en-Y hepaticojejunostomy is associated with lower extent of trauma, faster recovery, less inflammation, and fewer complications than open surgery in adult patients with Type-I congenital choledochal cysts.
比较成人Ⅰ型先天性胆总管囊肿开放手术和腹腔镜手术的疗效。
回顾性分析2021年9月1日至2022年8月31日在郴州市第一人民医院接受囊肿切除及 Roux-en-Y 肝空肠吻合术的78例成人Ⅰ型先天性胆总管囊肿患者的临床资料。接受开放手术及 Roux-en-Y 肝空肠吻合术的患者组成开放手术组（n = 35），接受腹腔镜手术及 Roux-en-Y 肝空肠吻合术的患者组成腹腔镜手术组（n = 43）。比较两组患者的术中及术后情况、相关实验室指标及并发症发生率。
腹腔镜手术组的术中出血量、术后首次排气时间、饮食恢复时间、引流管拔除时间及住院时间均低于开放手术组（P<0.05）。术后第1天，两组患者血清淀粉酶（SAMY）水平均显著降低，而总胆红素（TBIL）、谷丙转氨酶（ALT）及C反应蛋白（CRP）水平均高于术前。腹腔镜手术组术后SAMY水平显著高于开放手术组，而术后TBIL及CRP水平显著低于开放手术组（P<0.05）。腹腔镜手术组术后并发症发生率（4.65%）显著低于开放手术组（20.00%）（P<0.05）。
对于成人Ⅰ型先天性胆总管囊肿患者，腹腔镜囊肿切除联合 Roux-en-Y 肝空肠吻合术与开放手术相比，创伤小、恢复快、炎症反应轻且并发症少。
